NCG150068_Renewal COC Request Review_20221129

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/22/2022 9:07:22 AM (COC Request Submission)
Submit by Carson, Brittany D 11/29/2022 8:33:14 AM (Review COC Request for NCG150068)
• Georgoulias, Bethany A reassigned the task to Carson, Brittany D 11/22/2022 9:33 AM
Here's the request for the new NCG15 COC. You can choose the option that allows you create a
new COC and enter the correct waterbody info. Be sure to check BIMS and enter the correct
* issuance/effective dates so it reflects the renewal dates. We'll revise the name when it's saved in
Laserfiche to distinguish this new one from the default one that went out at renewal the first time. -
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• The task was assigned to Georgoulias, Bethany A. The due date is: November 25, 2022 5:00 PM
11/22/2022 9:07 AM

Permit COC Number* NCG150068
Enter the Certificate of Coverage (COC) number. MUST BEGIN WITH CAPITAL "NCG"
NOTE: You can verify the COC facility information and renewal status by running this Permit Summary Report (check the
Permit Status at the top of the report). If the permit is expired, a renewal COC will not be available. This may be
because fees are owed. You can check for outstanding invoices at https://deq.nc.gov/sw-epayments.
the COC is still expired, but owed fees have been paid.
permit information is incorrect or old.
What is incorrect? The receiving water body and the class designation of receiving water body as well
as the name of the facility is incorrect.
The name of the facility is just "U.S. Coast Guard Base Elizabeth City", the
Receiving Water Basin is the Pasquotank River and the Class of the receiving water
is SB.
Master General Permit NCG150000
Issuance Date* 06/30/2022
Master General Permit Issuance
Effective Date 07/01/2022
Master General Permit Effective
Name of Person Chris Dunn
Requesting COC* First and Last Name
Phone Number* [phone]
Email* [e-mail]
The COC will be e-mailed to this contact.
Additional Email [e-mail]
(Optional) Enter an additional email address to whom to send the COC
I hereby request a copy of the Certificate of Coverage (COC) entered above. I understand that the COC e-mailed as a
result of this request will serve as the Permittee's record of renewed coverage under the General Permit, and that this
record must be maintained with the Permittee's NPDES Stormwater Permit records. If a COC is not available, I request a
follow-up from Stormwater Program staff.
In addition, I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act"); and I agree to conduct this transaction by electronic means pursuant
to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
Signature
Date * 11 /22/2022
Time 09:07:22 AM
Permittee * Verify owner/operator is correct.
United States Coast Guard Elizabeth City Base Support Center

Facility Name* United States Coast Guard Base Elizabeth City
Verify facility name is correct.
Address 1664 Weeksville Rd
City Elizabeth Cty
County Pasquotank
Is the COC eligible Check to see if it has already been renewed/created before choosing "Yes"
for renewal or . Yes (will generate a new COC).
revision?* No, fees are still outstanding.
No, it was already renewed and is available.
No, for another reason.
If the COC needs to be renewed or corrected, enter waterbody information and appropriate dates below.
Receiving Water(s) * Enter all unique receiving waters identified in BIMS.
Pasquotank River
Waterbody (e.g., WS-IV) List multiple classifications as they should read on the COC.
Class ification(s)* SB
River Basin(s) * Enter the name of the river basin(s) the receiving waters drain in.
Pasquotank
(Just the Basin name. Do not include the words 'River Basin")
COC Issuance Date* 7/1/2022
COC Effective Date* 7/1/2022
COC status in BIMS Choose Active if you have just renewed the COC successfully.
Now* • Active
Expired
Inactive
Comments Additional information to convey to requester in e-mail communication.
Document(s) to add Documents that may be helpful to send requester (e.g., fees owed letter or BIMS screen shot).
to records PDF or JPG allowed
Request Instance ID 114118
For request tracking purposes only.
Review Date* 11/29/2022